Glaucoma

Q: My mother and grandmother have glaucoma. Can I have glaucoma and not know it? How is it diagnosed and treated?

A: Glaucoma is a condition in which the optic nerve in the back of the eye becomes damaged. In most cases, this damage is due to an increase in intraocular pressure (IOP). A family history of glaucoma does increase the risk that one may develop glaucoma.

To understand glaucoma, one must become familiar with the anatomy of the eye. Aqueous humor is a fluid produced in the eye. This fluid is normally drained out of a group of structures in the front of the eye called the angle. Impaired outflow of the aqueous humor may lead to an increased IOP and resultant optic nerve damage.

In most cases, the progression of glaucoma is slow and patients may have no symptoms in the early course of the disease. Therefore, it is possible to have glaucoma and not know it. During a routine eye examination, your eye doctor will check your IOP and carefully assess your optic nerves for any signs of glaucoma. If there are any suspicions for glaucoma, your doctor will perform additional testing such as computerized optic nerve analysis and a visual field examination. Since optic nerve damage from glaucoma first leads to peripheral vision loss, a visual field examination will carefully assess your peripheral vision for any early changes. If left untreated, however, advanced glaucoma may lead to central vision loss and blindness.

If the doctor diagnoses you with glaucoma, the most common treatment involves the use of daily eye drops or an in office laser treatment to lower the IOP. These medications will either decrease aqueous humor production or increase the outflow through the drainage channels in the angle. The doctor will carefully monitor the eye pressure to ensure that it has been lowered to an acceptable level. The doctor will also routinely perform additional tests to check for any signs of progression of the disease. The goal of glaucoma treatment is to prevent vision loss. If there are any signs of disease progression, your doctor may add more medications or consider laser and surgical treatment options.